New biograft solution, growth factors and bone regenerative approaches in neurosurgery, dentistry, and orthopedics: a review.

Bone regeneration following surgery, trauma, or any other condition is an autologous process that can fail, necessitating the requirement of novel procedures and materials. Recently, significant progress has been made in the research related to regenerative medicine. At the same time, biomedical implants in spine surgery, orthopedics, and dentistry are facing many challenges and posing clinical concerns. A PubMed, MEDLINE, and Scopus review was carried out to identify all studies dealing with bone regenerative approaches in dentistry, orthopedics, and neurosurgery from database inception to December 2022. There has been an upsurge in the implication of a multitude of materials in the enhancement of bone regeneration and/or neo-bone formation, including blood-derived growth factors, new biografts, biosynthetic polymers, inorganic compounds, and sea corals, in the very recent years. Stem cells (SCs) have been found to be efficacious and safe modalities in osteogenesis. Furthermore, bone regeneration/formation depends on the host's immune system and metabolic condition. Epidermal growth factors (EGFs) and their receptors (EGFRs) are important in the mechanism of wound repairing and healing through the recruitment of stromal stem cells for epidermal and dermal regeneration. Similarly, biocomposite developed from Silica assembled with calcium and phosphorous has been utilized in the treatment of broken bones. In this review, we summarized the clinical and laboratory evidence of bone regenerative approaches in the field of spine surgery, orthopedics, and dentistry. An accurate pre-operative screening is the key to managing and carefully planning all surgical steps and achieving the final success.

Effectiveness of computer-assisted anesthetic delivery system (sta™) in dental implant surgery: a prospective study.

OBJECTIVES: This prospective cohort study aimed to investigate effectiveness of Computerized Local Anesthesia (CLA) on oral implantology through estimation of pain and discomfort and total quantity of injected anesthetic. METHODS: Forty-five consecutive patients whose treatment plan included immediate or late dental implants were included in this study. The main inclusion criteria comprised: previous implant intervention under conventional anesthesia (CA) during the past 3 years and no previous treatment of pain relief. All patients reported on a 0-10 scale on previous experience with CA, and new experience with CLA. The same CLA system, namely Single Tooth Anesthesia (STA) was used for all patients with half of the quantity normally used for CA. Data on quantity of anesthetic and reported ratings were collected and described. Potential associations and determinant variables were analysed through correlation analysis and regression models. RESULTS: Out of 45 patients, 27 received post-extractive implant surgery whereas the rest 18 implant surgery on healed sites. The reported pain from STA (mean 1.6, SD 0.7) showed important difference as compared to CA (7.9, SD 1.2; z=5.873; p<0.0001). The comfort perceived during the STA ranged from 7 to 10 (mean 9.5, SD 0.79). A second injection with half of the initial dose was necessary in three cases only. CONCLUSIONS: STA system proved to be effective during interventions of dental implantology, by markedly reducing patients' pain and discomfort and the total quantity of necessary anesthetic.

Oral hygiene in patients with oral cancer undergoing chemotherapy and/or radiotherapy after prosthesis rehabilitation: protocol proposal.

PURPOSE: This study was aimed at assessing the effectiveness and the importance of an oral hygiene (OH) protocol in patients undergoing radiation therapy and chemotherapy after prosthesis rehabilitation, in order to reduce or minimize oral complications. MATERIALS AND METHODS: This study was carried out at the Department of Dental Science, at the University of Bari-Italy from December 2012 to December 2015 on 34 selected patients with primary oral cancer undergoing chemotherapy and radiotherapy after prosthesis rehabilitation. They were divided into 2 groups according to their age, sex and cancer therapy. Seventeen patients were assigned to the control group and seventeen in the experimental one. In the experimental group (Table 1), patients underwent an oral hygiene protocol whereas in the control group (Table 2) patients received the usual care provided within the clinical setting. All the patients gave written informed consent. It has been asked and obtained the authorisation from the Ethics Committee of the Dental Science and Surgery Department. RESULTS: Results show that in patients undergoing the oral hygiene protocol, the complications and the risks of infection and permanent dental problems have been minimized. Indeed, of the seventeen patients undergoing the OH protocol, 70% obtained positive results and were satisfied with the program outcome. CONCLUSIONS: The role of the health care providers is essential to educate patients to adhere to the prescribed treatments and reinforce their motivation in oral hygiene. The oral hygiene procedures prevent and ameliorate oral complications due to the radiation therapy and chemotherapy.

Cytogenetic genotoxic investigation in peripheral blood lymphocytes of subjects with dental composite restorative filling materials.

Dental composite resins are biomaterials commonly used to aesthetically restore the structure and function of teeth impaired by caries, erosion, or fracture. Residual monomers released from resin restorations as a result of incomplete polymerization processes interact with living oral tissues. The objective of this study was to evaluate the genotoxicity of a common dental composite material (Enamel Plus-HFO), in subjects with average 13 filled teeth with the same material, compared to a control group (subjects having neither amalgam nor composite resin fillings). Genotoxicity assessment of composite materials was carried out in vitro in human peripheral blood leukocytes using sister-chromatid exchange (SCE) and chromosomal aberrations (CA) cytogenetic tests. The results of correlation and multiple regression analyses confirmed the absence of a relationship between SCE/cell, high frequency of SCE(HFC) or CA frequencies and exposure to dental composite materials. These results indicate that composite resins used for dental restorations differ extensively in vivo in their cytotoxic and genotoxic potential and in their ability to affect chromosomal integrity, cell-cycle progression, DNA replication and repair.

Quality of life in fibromyalgia patients with craniomandibular disorders.

Fibromyalgia (FM) is a rheumatic disease which affects fibrous tissues and muscles; it is characterized by chronic pain and it is often associated with craniomandibular disorders (CMD). 31 patients were assessed from March 2012 to October 2012 through the administration of specific questionnaires and following neurologic and gnatologic assessment. A relevant corre-lation between FM and CMD emerges from the present study, as 80.6% of our patients report CMD symptoms with high prevalence of myofascial pain (84%). Multivariate regression analysis revealed that the patients in the present study did not differ in score of quality of life questionnaires from patients with fibromyalgia. The neuropathic pain diagnostic question-naire (DN4) scores were positively affected by belonging to group II of Research Diagnostic Criteria of Temporomandibular Disorders (RDC/ TDM) classification, suggesting the possibility of a neuropathic component in chronic pain in this CMD group, as already speculated in our study on the correlation between burning mouth syndrome and CMD and by other au-thors in studies on chronic low back pain. However, further clinic and instrumental studies are needed in order to test this as-sumption.

[Prosthetic rehabilitation of edentulous patients after stroke]. / Riabilitazione protesica di pazienti edentuli con esiti di stroke.

AIM: Stroke is actually the 3rd cause of death in the world after cardiovascular diseases and cancer. In Italy, every year there are 100000 new cases; 2/3 of them die or become heavily disabled. The greatest part of patients which survive is old-aged and 70% of patients that survive is a removable denture wearer. METHODS: At the Neurological Clinic of the Polyclinic Hospital of Bari we have studied 14 removable denture wearers that had had a stroke. RESULTS: We observed that 85.7 % of removable dentures were inefficient, in 50% there will need a new removable prosthesis; 50% of persons had a bad dental hygiene; 93% of denture wearers with stroke didn't make an odontoiatric control after stroke. CONCLUSIONS: Although the analysis of the orodental status has been carried out on a limited number of patients, the need of a greater motivation and solicitation in dental check-up is underlined. The role of the dentist in oral rehabilitation and in rehabilitation of post stroke dysphagia in stroke survivors is also examined.

[Correlation between edentulism, sleep disorders and arterial hypertension. Preliminary research]. / Correlazione fra edentulismo, disturbi del sonno e ipertensione arteriosa. Indagine preliminare.

BACKGROUND: Respiratory disturbances during sleep are considered risk factors for arterial hypertension and cardiovascular diseases. Edentulism, by decreasing retro-pharyngeal space, may favor upper airway occlusion during sleep. Aim of the study is to evaluate whether edentulism is associated with greater prevalence of sleep disturbances, arterial hypertension and other cardiovascular diseases. METHODS: Eighty edentulous subjects with dentures (removed during sleep) and 57 subjects with natural teeth, matched for age, underwent assessment of oral conditions and recording of questionnaires on diseases and respiratory sleep disturbances. RESULTS: Edentulous subjects had a significantly higher prevalence of arterial hypertension and cardiovascular diseases, than subjects with natural teeth. CONCLUSIONS: In edentulous subjects, removing dentures during sleep may favor respiratory disorders, and increase the risk for hypertension and cardiovascular disease.

[Squamous cell carcinoma in oral lichen ruber planus. A clinico-pathological and immunohistochemical study of 11 cases]. / Carcinoma squamoso su lichen ruber planus orale. Studio clinico-patologico ed immunoistochimico di 11 casi.

The malignant transformation of lichen ruber planus (LRP) is a quite frequent event for which, at present, no clear pathogenetic explanation has been given. Recently, attention has been paid to growth factors and growth factor receptors as possible pathogenetic factors of malignancy, even if not enough studies have been performed to exploit their role in oral diseases. Aim of the present study was to investigate the expression of epidermal growth factor receptor (EGFr) in squamous carcinomas arising in patients with LRP. The study has been performed on formalin-fixed, paraffin-embedded tissue biopsies obtained from 11 patients with previous diagnosis of LRP in which squamous carcinoma had developed. A monoclonal anti-EGFr antibody has been used, with the ABC technique, on histological sections. EGFr has been immunolocalized in basal and suprabasal epithelial layers in LRP with the highest intensity of staining in the areas with strong inflammation. EGFr immunostaining could be detected in dysplastic areas as well, even if the intensity of staining seemed to decrease with severity of dysplasia. In well-differentiated squamous carcinoma EGFr was intensely expressed, especially in mature keratinized cells. Weaker or absent EGFr immunoreaction was detected in moderately and poorly differentiated carcinomas. The results of the present study seem to show that EGFr is expressed in squamous carcinomas arising from LRP. The variability of EGFr expression in inflamed oral mucosa, in dysplastic areas and in tumors with different degrees of differentiation seem to point out that EGFr might somehow regulate the maturation and replication of epithelial cells in LRP and in its malignant counterpart. The speculations achieved from the present study need further evaluation on wider series of cases and, possibly, with different antibodies which would allow the identification of mutant forms of the receptor.